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Pneumothorax

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Definition:
A pneumothorax is a collapsed lung. A pneumothorax occurs when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse. In most cases, only a portion of the lung collapses..

It is the collection of air or gas in the space inside the chest around the lungs, which leads to a lung collapse.

Normally, the pressure in the lungs is greater than the pressure in the pleural space surrounding the lungs. However, if air enters the pleural space, the pressure in the pleura then becomes greater than the pressure in the lungs, causing the lung to collapse partially or completely. Pneumothorax can be either spontaneous or due to trauma.

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If a pneumothorax occurs suddenly or for no known reason, it is called a spontaneous pneumothorax. This condition most often strikes tall, thin men between the ages of 20 to 40. In addition, people with lung disorders, such as emphysema, cystic fibrosis, and tuberculosis, are at higher risk for spontaneous pneumothorax. Traumatic pneumothorax is the result of accident or injury due to medical procedures performed to the chest cavity, such as thoracentesis or mechanical ventilation. Tension pneumothorax is a serious and potentially life-threatening condition that may be caused by traumatic injury, chronic lung disease, or as a complication of a medical procedure. In this type of pneumothorax, air enters the chest cavity, but cannot escape. This greatly increased pressure in the pleural space causes the lung to collapse completely, compresses the heart, and pushes the heart and associated blood vessels toward the unaffected side.
Symptoms:
The symptoms of pneumothrax depend on how much air enters the chest, how much the lung collapses, and the extent of lung disease.

The main symptoms of a pneumothorax are sudden chest pain and shortness of breath. But these symptoms can be caused by a variety of health problems, and some can be life-threatening. If your chest pain is severe or breathing becomes increasingly difficult, get immediate emergency care.
Symptoms include the following, according to the cause of the pneumothorax:

*Spontaneous pneumothorax. Simple spontaneous pneumothorax is caused by a rupture of a small air sac or fluid-filled sac in the lung. It may be related to activity in otherwise healthy people or may occur during scuba diving or flying at high altitudes. Complicated spontaneous pneumothorax, also generally caused by rupture of a small sac in the lung, occurs in people with lung diseases. The symptoms of complicated spontaneous pneumothorax tend to be worse than those of simple pneumothorax, due to the underlying lung disease. Spontaneous pneumothorax is characterized by dull, sharp, or stabbing chest pain that begins suddenly and becomes worse with deep breathing or coughing. Other symptoms are shortness of breath, rapid breathing, abnormal breathing movement (that is, little chest wall movement when breathing), and cough.

*Tension pneumothorax. Following trauma, air may enter the chest cavity. A penetrating chest wound allows outside air to enter the chest, causing the lung to collapse. Certain medical procedures performed in the chest cavity, such as thoracentesis, also may cause a lung to collapse. Tension pneumothorax may be the immediate result of an injury; the delayed complication of a hidden injury, such as a fractured rib, that punctures the lung; or the result of lung damage from asthma, chronic bronchitis, or emphysema. Symptoms of tension pneumothorax tend to be severe with sudden onset. There is marked anxiety, distended neck veins, weak pulse, decreased breath sounds on the affected side, and a shift of the mediastinum to the opposite side.

Risk factors:

Risk factors for a pneumothorax include the following:

In general, men are far more likely to have a pneumothorax than are women.

1)Smoking. The risk increases with the length of time and the number of cigarettes smoked, even without emphysema.

2)Age. The type of pneumothorax caused by ruptured air blisters is most likely to occur in people between 20 and 40 years old, especially if the person is a very tall and underweight.

3)Genetics. Certain types of pneumothorax appear to run in families.

4)Lung disease. Having an underlying lung disease — especially chronic obstructive pulmonary disease (COPD) — makes a collapsed lung more likely.

5)Mechanical ventilation. People who need mechanical ventilation to assist their breathing are at higher risk of pneumothorax.
Previous pneumothorax. Anyone who has had one pneumothorax is at increased risk of another, usually within one to two years of the first.

Complications:
Many people who have had one pneumothorax can have another, usually within one to two years of the first. Air may sometimes continue to leak if the opening in the lung won’t close. Surgery may eventually be needed to close the air leak.

Diagnosis:
To diagnose pneumothorax, it is necessary for the health care provider to listen to the chest (auscultation) during a physical examination. By using a stethoscope, the physician may note that one part of the chest does not transmit the normal sounds of breathing. A chest x ray will show the air pocket and the collapsed lung. An electrocardiogram (ECG) will be performed to record the electrical impulses that control the heart’s activity. Blood samples may be taken to check for the level of arterial blood gases.

Treatment:
A small pneumothorax may resolve on its own, but most require medical treatment. The object of treatment is to remove air from the chest and allow the lung to re-expand. This is done by inserting a needle and syringe (if the pneumothorax is small) or chest tube through the chest wall. This allows the air to escape without allowing any air back in. The lung will then re-expand itself within a few days. Surgery may be needed for repeat occurrences.

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Prognosis:
Most people recover fully from spontaneous pneumothorax. Up to half of patients with spontaneous pneumothorax experience recurrence. Recovery from a collapsed lung generally takes one to two weeks. Tension pneumothorax can cause death rapidly due to inadequate heart output or insufficient blood oxygen (hypoxemia), and must be treated as a medical emergency.

Prevention:
Preventive measures for a non-injury related pneumothorax include stopping smoking and seeking medical attention for respiratory problems. If the pneumothorax occurs in both lungs or more than once in the same lung, surgery may be needed to prevent it from occurring again.
Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.mayoclinic.org/diseases-conditions/pneumothorax/symptoms-causes/dxc-20179900
http://medical-dictionary.thefreedictionary.com/Pneumothorax
http://www.mayoclinic.org/diseases-conditions/pneumothorax/home/ovc-20179880

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Just Say No to Nuts During Pregnancy

Recent research has found that regular consumption of nut products during pregnancy raises the odds of your child having asthma symptoms by nearly 50 percent.

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About 4 percent of American children have food allergies, and roughly 3 million people in the U.S. are allergic to peanuts or tree nuts. It’s already recommended that children under 3 not be given nuts or nut products, because their immune systems are still developing and may be more susceptible to allergens.

Daily consumption of nut products increases the odds that a child will have wheezing by 42 percent, shortness of breath by 58 percent, and steroid use to ease asthma symptoms by 62 percent.

Overall, the odds of developing asthma symptoms for a child whose mother ate nuts daily are 47 percent higher.

Sources:
U.S. News and World Report July 15, 2008

American Journal of Respiratory and Critical Care Medicine July 15, 2008; 178(2):113-4

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Eating Nuts During Pregnancy Might Increase Asthma Risk

Children born to mothers who ate nuts or nut products daily were 50% more likely to have asthma than those whose moms avoided the foods, a Dutch study shows.

NO SURE THING: Asthma and asthma symptoms did occur in some children whose mothers, in a study, rarely or never ate nuts while pregnant.

What’s new: A pregnant woman who eats nuts or nut products every day during pregnancy may increase her child’s risk of developing asthma.

The finding: A large study by the Dutch government has found that children born to women who ate nuts or peanuts, or items made from them, such as peanut butter, daily while pregnant were 50% more likely to wheeze, have difficulty breathing or have asthma diagnosed by a doctor compared with children whose mothers rarely or never ate nuts or nut products while pregnant. The study, published in the American Journal of Respiratory and Critical Care Medicine this month, is part of a larger, ongoing research initiative, the Prevention and Incidence of Asthma and Mite Allergy study, which is investigating how allergies develop in children and how they can be prevented.

Another finding: The odds of developing one particular asthma symptom — wheezing –were reduced in children whose mothers ate fruit daily during pregnancy, but the design of the study made it difficult for the researchers to conclusively link the two in a cause-effect relationship.

How the study was done: Nearly 4,000 expectant mothers, recruited into the study more than a decade ago, completed a dietary questionnaire on how often they ate fish, eggs, milk and milk products, nuts and nut products, fresh fruit and vegetables. Researchers followed up on the women’s offspring at 3 months old and then once a year until the children were 8, gathering information about the children’s diets, allergies and asthma symptoms.

Aside from nuts, none of the other dietary components appeared to affect the children’s likelihood of developing asthma or asthma-related symptoms. The food the children ate also appeared to have no bearing on their risk of asthma. Only the children whose mothers ate nuts or nut products every day while pregnant were more likely to experience wheezing, shortness of breath or other asthma symptoms.

Why it matters: A scientifically validated link between what a woman eats and her child’s risk of a health problem would, of course, affect the advice doctors give to expectant mothers — and, it is hoped, reduce the incidence of that problem.

Numerous studies have tried to clarify the relationship between a woman’s diet during pregnancy and the development of asthma or allergies in her child. Researchers have found that some vitamins and minerals (such as vitamin D and iron), as well as some foods (such as fish and apples), may protect against asthma and allergies. Others have shown that exposure to peanuts while in utero may increase a child’s risk of developing an allergy to them. But the current study, its authors say, is the first of its kind to follow up with its participants repeatedly over a long period, and thus is expected to be more reliable.

This study is also significant for what it didn’t show. Unlike those earlier studies that found that eating more fish during pregnancy can reduce the risk of asthma or allergies in offspring, the Dutch researchers produced no evidence to support those findings. (They were unable to draw conclusions about apples or specific vitamins or minerals, however, because they didn’t ask mothers for such dietary details.)

What we still don’t know: How could fetal exposure to nuts trigger asthma? Scientists have proposed a number of ideas, but the precise mechanisms are still unknown. Though the study suggests a link between nut consumption and asthma, it doesn’t show that a woman who avoids nuts during pregnancy has found a surefire way to prevent asthma in her offspring: Asthma and asthma symptoms did occur in some children whose mothers rarely or never ate nuts while pregnant. The study may be large and well designed, but its findings will need to be replicated before its results can join the legions of advice given to pregnant women across the globe.

Sources: Los Angles Times

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